Micro-syringe as a result of the high frequency of clinical use, direct contact with patients, the failure of its equipment will have a direct impact on the patient's disease status. Researchers in this paper, by simulating the test fluid, electrical safety testing and analysis of statistical methods such as maintenance records, consider six kinds of common injection pump, in terms of performance, safety and the failure rate of three performance. Compared the performance analysis, summarized the various types of injection pump characteristics, researchers make suggestions to clinical departments, equipment procurement and equipment management departments for usage and improvement.
Equipment Failure ; Equipment Safety ; Syringes

Objective To investigate the prognosis and recurrent factors of primary retroperitoneal liposarcoma (PRPLS).Methods The retrospective case-control study was conducted.The clinicopathological data of 51 patients with PRPLS who were admitted to the Southwest Hospital of the Third Military Medical University from January 2005 and March 2015 were collected.Observation indicators:(1) follow-up institution.(2) Analysis of prognostic factors:gender,age,tumor diameter,combined organs resection,pathological type,cancer risk and local recurrence.(3) Analysis of recurrent risk factors:gender,age,tumor diameter,combined organs resection,pathological type and cancer risk.(4) Stratified analysis:the independent risk factors of recurrence were done by the stratified analysis.(5) Correlation between cancer risk and tumor diameter or number of organs invaded.(6) Correlation between adjacent organ invasion and tumor diameter.Follow-up using outpatient examination and telephone interview was performed to detect the survival of patients and tumor recurrence up to October 2015.The survival rate and curve were respectively calculated and drawn by KaplanMeier method.The univariate analysis and survival analysis were done using the Log-rank test.The multivariate analysis was done by the COX regression model.The correlation analysis was done using the Pearson test.Results (1) Follow-up institution:51 patients were followed up for 3-114 months,with a median time of 43 months.The 3-year survival rate of 51 patients was 70.6％.Twenty-two patients had the first local recurrence,with a recurrent time of 3-60 months and a median time of 29 months.(2)Analysis of prognostic factors:the results of univariate analysis showed that tumor diameter,combined organs resection,pathological type,cancer risk and local recurrence were the related factors affecting prognosis of patients with PRPLS (x2 =5.926,4.936,17.856,17.279,14.568,P ＜ 0.05).The results of multivariate analysis showed that combined organs resection,pathological type and cancer risk were the independent factors affecting prognosis of patients with PRPLS [OR =0.538,0.645,9.620,95％ confidence interval (CI):0.238-0.997,0.458-1.058,1.692-18.714,P ＜ 0.05].(3) Analysis of recurrent risk factors:the results of univariate analysis showed that pathological type and cancer risk were the related factors affecting recurrence of patients with PRPLS (x2 =12.375,12.364,P ＜ 0.05).The results of multivariate analysis showed that cancer risk was an independent factor affecting recurrence of patients with PRPLS (OR =6.234,95％ CI:1.419-27.377,P ＜ 0.05).(4) Stratified analysis:the 3-year survival rates of 11 patients with low risk of recurrence of PRPLS and with high risk of recurrence of PRPLS were 63.6％ and 9.1％,respectively,with a statistically significant difference (x2 =12.364,P ＜ 0.05).(5)Correlation between cancer risk and tumor diameter or number of organs invaded.Tumor diameter and number of organs invaded were respectively (17 ±8)cm,1 ± 1 in 33 patients with low risk of PRPLS and (19 ±5)cm,2 ± 1 in 18 patients with high risk of PRPLS,with no statistically significant difference in tumor diameter (r =0.222,P ＞ 0.05) and with a statistically significant difference in number of organs invaded (r =0.666,P ＜ 0.05).(6)Correlation between adjacent organ invasion and tumor diameter.Tumor diameter was (16 ± 8) cm in 19 patients without adjacent organ invasion and (19 ± 7)cm in 32 patients with adjacent organ invasion,respectively,showing no statistically significant difference (r =0.225,P ＞ 0.05).Conclusions The combined organs resection,pathological type and cancer risk are independent factors affecting prognosis of patients with PRPLS,and cancer risk is an independent factor affecting recurrence of patients with PRPLS.The prognosis of patients with low risk of PRPLS is better than that with high risk of PRPLS.The organ invaded is much likely to occur in patients with high risk of PRPLS.

Objective;To explore the relationship among parents' negative punishment,children's self-concept,and children's social behaviors.Methods;Data were collected from questionnaires given to a sample of 612 children from primary and secondary schools and their parents.Results;The structural equation modeling results showed parents' negative punishments could influence children's social behaviors directly and indirectly.In the indirect approach,through the mediating role of children's self-concept,parents' negative punishments could make a negative role on children's pro-social and aggressive behaviors,and a positive role on children's withdrawn behavior.In the direct approach,parents' negative punishments could make a positive effect on children's pro-social,aggressive and withdrawn behavior directly.Conclusion;Children's self-concept plays a mediating role between the relationship of parents' negative punishments and children's social behaviors.

OBJECTIVETo investigate the effects of total flavonoids of Chrysanthemum indicum (TFC) on metabolism of free radical and immunoregulatory effects in adjuvant arthritis (AA) rats.

METHODAA rats were induced by Freunds complete adjuvant. Secondary paw swelling of AA rats was measured with volume meter to observe the antirheumatic effect of TFC. The levels of SOD, MDA and NO in serum and supernatant of peritoneal macrophage were measured by commercial assay kits. ConA-induced splenocyte proliferation and IL-2 level produced by splenocyte were detected by MTT method.

RESULTTFC could decrease the levels of MDA and NO, as well as increase the activity of SOD in serum and supernatant of peritoneal macrophage compared with AA model group. Meanwhile, the suppressed lymphocyte proliferation and IL-2 production of splenic lymphocytes in AA rats were reversed by treatment with TFC.

CONCLUSIONTFC showed significant therapeutical effect on adjuvant arthritis and its mechanism was at least in part related to the antioxidant and immunoregulatory effects.

Animals ; Antioxidants ; metabolism ; Arthritis, Experimental ; drug therapy ; immunology ; metabolism ; Cells, Cultured ; Chrysanthemum ; chemistry ; Flavonoids ; chemistry ; therapeutic use ; Free Radicals ; metabolism ; Interleukin-2 ; metabolism ; Lymphocyte Activation ; drug effects ; Male ; Malondialdehyde ; metabolism ; Mice ; Mice, Inbred C57BL ; Nitric Oxide ; metabolism ; Rats ; Rats, Sprague-Dawley ; Spleen ; cytology ; Superoxide Dismutase ; metabolism

Objective: To evaluate the effects of the intervention based on WeChat on blood pressure control in patients with essential hypertension. Methods: The databases of CNKI，Wanfang，VIP，PubMed and the Cochrane Library were researched for the literatures about effects of the intervention based on WeChat on blood pressure control in patients with essential hypertension published from 2011 to 2018. These papers were retrieved and evaluated according to inclusion and exclusion criteria. Stata 12.0 software was used for meta analysis. Results: Eleven out of 880 papers were included into meta analysis. There were 1 174 cases，with 587 cases in the experimental group and 587 cases in the control group. The results of the meta analysis showed that compared with traditional health intervention method，the intervention based on WeChat significantly reduced the level of systolic blood pressure（WMD=14.77，95%CI：11.76-17.77）and diastolic blood pressure（WMD=8.17，95%CI：5.67-10.67）of hypertensive patients. Subgroup analysis showed that the longer the intervention，the better the effects（P<0.05）. Conclusion The intervention based on WeChat is more helpful than traditional health intervention for blood pressure control of patients with essential hypertension.

Objective: To compare the clinical efficacy of proximal gastrectomy with double tract reconstruction (PG-DT) and total gastrectomy with Roux-en-Y reconstruction (TG-RY) for proximal gastric cancer. Methods: The retrospective study was conducted. Clinicopathological data of 132 patients with proximal gastric cancer confirmed by pathology who underwent PG-DT (n=51) or TG-RY (n=81) by the same surgeon team in Southwest Hospital of Army Military Medical University between January 2006 and December 2016 were collected. Patients with preoperative neoadjuvant therapy, non-R0 resection and non-adenocarcinoma confirmed by pathology were excluded. Observation indicators included intraoperative (operation time and blood loss); postoperative (time to flatus, hospital stay, total complications, metastasis of lymph nodes around distal side of stomach from cases undergoing TG-RY), follow-up (long-term hemoglobin level, incidence of anemia, and survival) parameters. Survival analysis was conducted using the Kaplan-Meier method, and Log-rank test was used to compare survival difference between two groups. Results: No statistically significant differences were found between two groups in the baseline data, including age, gender, BMI, hemoglobin level before operation, postoperative TNM stage, tumor size and histological differentiation between two groups (all P>0.05). There were no significant differences between PG-DT and TG-RY in intraoperative blood loss [200 (200) ml vs. 200 (195) ml, Z=-1.860, P=0.063], time to flatus [(2.7±1.0) days vs. (2.6±1.1) days, t=0.225, P=0.823], postoperative hospital stay [10(3) days vs. 10 (4) days, Z=-0.449, P=0.654] and morbidity of perioperative complications [5.9% (3/51) vs. 8.6% (7/81), χ²=0.081, P=0.775]. Compared with the TG-RY group, PG-DT group had longer total operative time [294 (97) minutes vs. 255 (71) minutes, Z=–3.148, P=0.002]. The hemoglobin data of 42 patients with PG-DT and 56 patients with TG-RY were collected 1 year after operation. The incidence of anemia in PG-DT group was lower than that of TG-RY group [64.2%(27/42) vs. 82.1% (46/56), χ²=4.072, P=0.045], and PG-DT group had higher level of hemoglobin than TG-RY group [(114.4±16.3) g/L vs. (106.6±15.0) g/L, t=2.435, P=0.017]. There were 4 cases (4/81, 4.9%) with metastasis of lymph nodes around distal side of stomach in TG-RY group. All of these 4 tumors were T4 in depth and were more than 5 cm in diameter. The median follow-up period was 26 (1 to 110) months. One-year, 3-year and 5-year survival rates were 93.2%, 65.3% and 55.0% in PG-DT group, and 85.8%, 63.8% and 47.2% in TG-RY group, respectively without significant difference (χ²=0.890, P=0.345). Conclusions Compared with TG-RY, PG-DT has the same safety and feasibility for proximal gastric cancer. Although the operative time is a little longer than TG-RY, PG-DT has advantages in improving the postoperative hemoglobin level.

Purpose:The study was designed to investigate the feasibility of contrast-enhanced ultrasound in the differentiation of benign and malignant adnexal masses.Materials and Methods:Sixty-nine consecutive patients with adnexal masses received trans vaginal contrast-enhanced ultrasound.The image and perfusion features were assessed.Results:All of 26 malignant tumors showed detectable contrast enhancement,including 24 cases with a quick,heterogeneous or branching pattern.Among 39 benign lesions,24 were cystic with circle or half-circle enhancement,including 5 cases with intra-cystic septum or papillae slightly enhanced.The other 15 cases were solid,8 of them had slightly dotted enhancement.There are significant difference in enhancement patterns between benign and malignant masses ( P < 0.0001).The 4 cases of borderline tumors showed progressive,heterogeneous enhancement.Conclusion:Contrast-enhanced ultrasound is of value in the differentiation of benign and malignant adnexal masses.

Objective To investigate the citizen's attitude towards the cognition of brain death and the legislation of brain death criteria. Methods A questionnaire survey was performed in 1 500 outpatients or accompanying personnel by the convenient sampling method. The questionnaire data were independently recorded by two professionals using the Epidata 3.02 software. The factors influencing the citizen's support of the legislation of brain death were analyzed by univariate and multivariate Logistic regression models. Results Among 1 433 eligible respondents, 84.65% (1 213/1 433) of them knew brain death, and 24.32% (295/1 213) considered brain death as a reasonable criterion for death. The proportion of respondents who supported and opposed the legislation of brain death was 49.79% (604/1 213) and 17.31% (210/1 213).Male [odds ratio (OR)=1.3, 95% confidence interval (CI) 1.0-1.6], those with junior college degree or above at educational level (OR=1.5, 95%CI 1.1-1.9), those whose relatives and friends were engaged in organ donation (OR=3.3, 95%CI 1.1-10.3), those who participated in public welfare activities of organ donation (OR=3.1, 95%CI 1.6-6.0) and those who regarded brain death as a reasonable criterion for death (OR=2.0, 95%CI 1.5-2.6) were more inclined to support the legislation of brain death, which were the independent influencing factors of the legislation of brain death (all P < 0.05). Conclusions Citizens have relatively low cognition and support of the legislation of brain death criteria. Relevant propaganda on brain death should be widely carried out to strengthen the citizen basis for the legislation.

OBJECTIVETo explore the surgical techniques and feasibility of robotic surgery for carcinoma in the remnant stomach(CRS).

METHODSClinicopathological data of 20 CRS patients undergoing robotic surgery at the Minimally Invasive Center for Gastrointestinal Surgery, Army Medical University Southwest Hospital from November 2012 to October 2017 were retrospectively collected. The surgical methods, procedures, main difficulties, and key techniques were analyzed, and the clinical efficacy was evaluated.

RESULTSAmong 20 CRS patients, 14 were male and 6 were female with mean age of 59.9 years and mean BMI of 19.7 kg/m. For the primary diseases, 17 patients underwent laparotomy, 3 underwent laparoscopic radical resection of gastric cancer; 18 cases received distal subtotal gastrectomy plus Billroth II( anastomosis, 2 received distal subtotal gastrectomy plus Billroth I( anastomosis. CRS located in anastomotic stoma in 15 cases and in the gastric fundus and cardiac part in 5 cases. Preoperative staging revealed 2 cases of T2NxM0, 1 of T3NxM0, 2 of TxNxM0 and 15 of T4aNxM0. Sixteen patients received robotic surgery with Roux-en-Y reconstruction successfully, and 4 patients were converted to laparotomy for palliative total gastrectomy, including 1 case with diaphragm invasion, 1 case with transverse colon invasion, and 2 cases with tight adhesions. The mean surgery time was (255±35) minutes, mean blood loss was (230±50) ml, mean number of dissected lymph nodes was 19.5±3.0, mean recovery time to gastrointestinal function was (2.3±1.0) days, mean time to feeding was (2.3±1.0) days, and mean time to ambulatory activity was (2.5±0.5) days. Pathological examinations revealed 12 patients with poorly differentiated adenocarcinoma, 6 patients with moderately differentiated adenocarcinoma, and 2 patients with mucinous adenocarcinoma. Postoperative pTNM staging was identified as follows: stage I(B for 1 patient, stage II(A for 2 patients, stage II(B for 5 patients, stage III(A for 5 patients, stage III(B for 4 patients, and stage III(C for 3 patients. One patient died 2 weeks after operation due to multiple organ failure. One patient received another hemostasis operation due to hemorrhage of splenic artery and recovered postoperatively. Two patients experienced anastomotic leakage, 1 patient developed duodenal stump fistula and 1 patient experienced incision site infection postoperatively, and all of them recovered after conservative treatment. During 5-60 months follow-up, 10 cases died and 10 cases survived, including 1 case for 6 years.

CONCLUSIONSRobotic surgery for CRS is feasible with satisfactory short-term efficacy. However, the long-term efficacy requires further study.

Female ; Gastrectomy ; Gastric Stump ; surgery ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Robotic Surgical Procedures ; Stomach Neoplasms ; surgery

OBJECTIVETo compare the efficacy between laparoscopic and open surgery in the treatment of gastric gastrointestinal stromal tumor (gastric GIST), and to explore the feasibility and safety of laparoscopic resection for gastric GIST.

METHODSClinical data of 226 gastric GIST patients confirmed by pathology with maximal tumor diameter less than 10 cm undergoing operation in our department from January 2002 to December 2013 were retrospectively analyzed. Among them, 158 patients received laparoscopic surgery(laparoscopic group), and 68 open surgery (open group). Related indicators of clinical efficacy were compared between the two groups. Laparoscopic group patients were further divided into 4 groups according to chronological order, including 39 patients in group A, 39 in group B, 39 in group C and 41 in group D. Operating time was compared among 4 groups.

RESULTSCompared with the open group, laparoscopic group had shorter operation time [(138.8±69.2) min vs. (173.3±74.5) min, P=0.001], less intraoperative bleeding [30 ml vs. 125 ml, P=0.000], faster recovery to postoperative first flatus [(3.2±1.1) d vs. (3.8±1.1) d, P=0.000] and resumption of oral intake [(3.9±1.5) d vs. (4.7±1.5) d, P=0.000], and a shorter hospital stay [(8.1±2.3) d vs. (10.0±2.6) d, P=0.001]. The operation time of laparoscopic group A, B, C and D was (181.0±81.2) min, (124.7±57.8) min, (126.9±67.9) min and (123.4±51.8) min respectively, and the difference was statistically significant(F=7.188, P=0.001). Median follow-up time of 226 patients was 32 months(5 to 104 months). In laparoscopic group, 136 cases(86.1%) received follow-up, and the 1-, 3-, and 5-year overall survival were 98.7%, 90.7% and 72.8% respectively. In the open group, 59 cases (86.8%) received follow-up, and the 1-, 3-, and 5-year overall survival were 98.3%, 87.1% and 83.1%, respectively. The survival between two groups were not significantly different(P=0.164).

CONCLUSIONSLaparoscopic surgery removing gastric GIST with a maximal diameter of less than 10 cm is safe and feasible. The learning curve of laparoscopic gastric GIST surgery is about 40 cases.

Gastrectomy ; Gastrointestinal Neoplasms ; Gastrointestinal Stromal Tumors ; Humans ; Laparoscopy ; Length of Stay ; Operative Time ; Postoperative Period ; Retrospective Studies ; Safety